Long-term cephalometric changes in untreated adults compared to those treated with orthognathic surgery

A surprisingly large amount of long-term remodeling of facial structures has been noted in the period between 1 and 5 years post-orthognathic surgery. To evaluate whether these changes are greater than in patients with similar morphology who did not have surgery, long-term changes in hard tissue landmarks were examined in 33 untreated adults and compared to long-term changes in skeletal Class II surgery patients who underwent maxillary impaction, mandibular advancement, or both. Although the changes were small in both groups, mean changes were greater in the surgical patients; the surgical patients also showed a higher percentage of significant changes. Horizontal changes were in a forward direction in the untreated group and a backward direction in the surgical groups. We conclude that normal adult growth cannot account for the long-term changes observed following jaw surgery. In some instances, postsurgical changes leading to relapse continue much longer than would have been expected.